Are iodinated contrast agents detrimental in acute cerebral ischemia? An experimental study in rats.

Abstract

PURPOSE: To study the effects of iothalamate sodium and two dosages of iopromide in acute cerebral ischemia on infarction volume, neurologic performance, and mortality in a rat model of middle cerebral artery occlusion. MATERIALS AND METHODS: Sixty-four rats underwent endovascular occlusion of the middle cerebral artery. Four hours later, 16 animals received iothalamate sodium (588 mg iodine per kilogram); 16, iopromide as a single bolus (518 mg iodine per kilogram); and 16, iopromide as a double bolus (1,036 mg iodine per kilogram). Sixteen animals received equivolumetric saline (control group). Neurologic score and body weight were recorded every 8 hours. Twenty-four hours after occlusion, all animals were killed; brains were stained to assess the infarction size. RESULTS: Single and double doses of iopromide did not affect infarction volume or neurologic performance. Iothalamate caused an increase in infarction volume and worsening of the neurologic score (p < .05). Mortality rate was 25% in the iothalamate group, 12% in the control group, and 6% in the iopromide groups. CONCLUSION: Bolus injection of the nonionic iopromide does not statistically significantly affect infarction volume or cerebral ischemia symptoms. Nonionic rather than ionic contrast agents should be preferred during acute cerebral ischemia.